Application of Freire’s Adult Education Model for Modifying the Psychological Constructs of Health Belief Model in Self-medication Behaviors of Elderly: a randomized controlled trial

Abstract

Background : As people age, they are more likely to engage in self-medication and suffer from its adverse effects. The present study aimed to modifying knowledge, psychological constructs of Health Belief Model (HBM), and self-medication behaviors using Freire’s Adult Education Model (FAEM) among elderlies in Khorramabad, Iran, from 2017 to 2018. Methods: This research was of a prospective randomized controlled trial conducted on 132 elderly individuals older than 60 who were referred from health care centers. The participants were selected using multistage sampling method and randomly divided into two groups of intervention and control. The data collection instruments included a questionnaire which was designed based on both HBM and the self-medication behaviors questionnaires. The phases of the adult education approach were used to modify the psychological constructs of HBM and self-medication behaviors. Data were analyzed using SPSS software version 20 with a significance level of 0.05. Descriptive statistical tests, the chi-squared test, paired t-test, independent t-test, and univariate modeling were employed for this purpose. Results : The mean age of the elderly was 66.28 ± 7.18 years. There was no significant difference between groups in terms of self-medicating. Unawareness of the effects of medicines were the most important causes of self-medication (p=0.50). The two groups were not significantly different in terms of knowledge, HBM constructs, and self-medication behaviors (p>0.05). However, they came up to be considerably different for the above variables after the intervention was completed (p<0.05). When the findings were adjusted for the effects of confounding variables, there were significant differences between almost all constructs of HBM and their behaviors ( p < 0.05). However, the perceived barrier modality of HBM did not reach to a significant level of difference between two groups. Conclusion: The educational intervention, which was based on FAEM, had positive effects on the constructs of HBM and consequently on self-medication behaviors. The psychological constructs of HBM were affected at the phases of listening to the problem and reflecting on it. Self-medication was tempered at the action-reflection phase with shared creation and evaluation of the action plan geared towards the achievement of the behavioral objectives.